17 plan coder jobs found in Springfield

QA Nurse / Coder (RN) As a QA Nurse / Coder, you will ensure the accuracy, completeness, and regulatory compliance of Home Health documentationparticularly OASIS assessments, the Home Health Plan of Care (485), and face-to-face encounter noteswhile properly sequencing diagnoses according to federal/state standards and agency policy. Core responsibilities include: Review OASIS forms and Plans of Care for appropriateness, completeness, and compliance. Assign and sequence ICD?10 codes in line with current home health coding guidelines. Ensure consistency and compliance of face-to-face encounter documentation with OASIS and care plans. Conduct additional clinical record audits and OASIS reviews as assigned. Stay current on Medicare reimbursement policies, home health regulations, and compliance requirements. Maintain relevant certifications (HCS?D, HCS?O or COS?C). Participate in quality assurance and performance-improvement efforts. Coordinate with physicians, facilities,...

New Jersey's largest Vascular Surgery group dedicated solely to the diagnosis and management of diseases of the arteries and veins. The Group has been delivering care throughout New Jersey since 1963 and is home to some of the best Vascular Surgeons in the country. Consistently recognized by their peers and patients as the top group in the region, The Cardiovascular Care Group provides the highest quality care using the newest technologies in the setting of years of experience with outstanding results. Position Summary: We are seeking an experienced Senior Vascular Surgery Professional Coder with strong expertise in complex open and endovascular procedure coding, payer authorization workflows, and revenue cycle support. This role is responsible for accurate CPT, ICD-10-CM, and modifier assignment for a high-volume vascular surgery practice with extensive cardiovascular, endovascular, catheter-based, and imaging-guided procedural work. The position also supports prior...

Coder OP McKenzie-Willamette Medical Center is your community medical provider, serving the Willamette Valley and its residents. Our 113-bed hospital offers inpatient, outpatient, diagnostic, medical, surgical and emergency care. We are a family of caregivers offering care to our larger family — our community. Position Details: Hourly Base Rate: $18.28 - $26.37 Shift: Days Hours Per Week: 40 hours Job Summary: Certified Coder required. Working knowledge of basic medical terminology, ICD-10, CPT and HCPCS codes. Preferred experience in multiple specialties including: Cardiology, Cardiology diagnostic testing, Cardiothoracic Surgery, Critical Care, General Surgery, Gastroenterology, Pulmonology, Vascular Surgery and Vascular Imaging services. Ability to assign codes to diagnoses, procedures, E&M visits, and diagnostic testing. Ability to research and analyze clinical documentation as well as produce reports from a variety of sources. Ability to...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. 1,500 Sign on Bonus We're looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule,...

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note:...

Location John H. Stroger, Jr. Hospital Department Health Information Management Shift 7:00 AM - 3:00 PM Pay Range $37.658 hourly Job Summary Under the supervision of a Coding Supervisor, the Health Information Management (HIM) Coder abstracts relevant clinical and demographic information from the medical record to identify the care rendered to the patient for the purpose of reimbursement, research and compliance. The HIM Coder ensures that the medical record reflects accurate attending physician documentation for coding of physician and facility encounters. Assigns ICD-10-CM and PCS codes, CPT-4, and HCPCS Level II codes in accordance with coding and reimbursement guidelines for physician and facility encounters. Abstracts into a group and assigns Diagnosis Related Group (DRG) on inpatient accounts and applies Ambulatory Payment Classifications (APC) to outpatient accounts. With minimal errors, identifies principal and secondary diagnosis and procedures based upon federally...

A healthcare company is seeking a detail-oriented Certified Medical Coder to work remotely. Responsibilities include analyzing medical records, assigning accurate codes for surgeries, and resolving billing issues. Ideal candidates will have at least 3 years of experience in a busy medical setting and must hold a current CPC or CCS certification. This full-time position offers a salary between $50,000 and $70,000, along with comprehensive benefits including health insurance and a retirement plan. #J-18808-Ljbffr

Overview Certified Medical Coder (CPC or CCS) - Remote | WFH job at Get It - Healthcare. Springfield, NJ. Job Summary: We are looking for a detail-oriented and motivated Certified Medical Coder to join our team. As a key member of the coding department, you will be responsible for ensuring the accuracy and quality of medical coding for surgical and hospital outpatient services. You\'ll play an essential role in reviewing patient medical records, assigning proper codes, and supporting billing processes to ensure smooth and efficient medical payment collection. This is an exciting opportunity to contribute your expertise while working remotely in a supportive and dynamic environment. Responsibilities Analyze medical records to assign accurate codes for services, procedures, diagnoses, and treatments. Resolve coding-related billing issues promptly and efficiently. Code and bill for vascular scans and other medical services. Assign appropriate ICD-10 and CPT codes for outpatient...

We are seeking a detail-oriented and experienced Managed Vision Care Biller to join our team in OakBrook Terrace. The ideal candidate will have a strong background in optical billing and be proficient with major vision care insurance providers including VSP, EyeMed, and Spectera. This role is essential in ensuring accurate and timely billing processes to maximize reimbursements and maintain compliance with insurance guidelines. Key Responsibilities Prepare and submit claims to managed vision care insurance providers such as VSP, EyeMed, and Spectera. Verify patient insurance eligibility and benefits prior to services. Review and process optical billing information accurately and efficiently. Follow up on unpaid or denied claims and resolve billing discrepancies. Maintain up-to-date knowledge of insurance policies, billing codes, and industry regulations. Collaborate with optical staff and insurance companies to ensure smooth billing operations. Maintain accurate records of billing...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD and CPT coding systems and assists in decreasing the average accounts receivable days. ESSENTIAL RESPONSIBILITIES Reviews and interprets medical information, physician treatment plans, course, and outcome to determine appropriate ICD-10 CM/CPT codes for diagnoses and procedures. (65%) Abstracts data elements to satisfy statistical requests by the hospital, health system, medical staff, etc. and enters all coded/abstracted information into designated system. (15%) Ensures efficient management of medical information and cash flow as it pertains to the unbilled coding report. (10%) Keeps informed of the changes/updates in ICD-10 CM/CPT guidelines by attending appropriate training, reviewing coding clinics and other resources...

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Job Description Job Description Description: About the Company: NextStep Technology Inc. is seeking a Medical Records Analyst. The medical records analyst is primarily responsible for review of health information. The MRA reviews the medical records for specific criteria and validation of specific code year sets submitted from selected organizations to government and commercial client. The position requires review of protected health information and must maintain strict confidentiality when addressing or referring to such records. The incumbent must have the ability to use a variety of office equipment, computer software, the ability to use sound and professional judgement, and to work independently. The candidate(s) will be hired as an employee up to 40 hours per week (flexible scheduling). This is a remote position About the Role: The medical records analyst is primarily responsible for review of health information. Responsibilities: Analyze protected...

Humana is seeking a Medical Coder / Coding Educator 2 to identify opportunities to improve provider documentation and to create education plans tailored to each assigned provider. This role reports to the Manager, Medicare Risk Adjustment. The candidate will arrange sessions, analyze coding quality with data visualization, and deliver on-site education while collaborating with market provider-facing teams. Up to 5% travel may be required. #J-18808-Ljbffr

Job Description We are hiring for Social Compliance & Human Rights auditors. UL Solutions is seeking experienced professionals in the Northeast Region near Massachusetts, New Jersey and Connecticut to join our mission of promoting responsible sourcing and protecting human rights across global supply chains. As a Responsible Sourcing Auditor, you’ll conduct on‑site assessments at factories and facilities—helping leading brands ensure their suppliers meet labor, safety, and sustainability standards. This role goes beyond compliance—it’s a chance to influence how companies operate and improve lives around the world. You’ll be part of a forward‑thinking team that values transparency, innovation, and your expertise. Responsibilities Perform independent, high‑quality audits focused on labor practices, health and safety, and ethical sourcing. Review documentation and prepare thoroughly for each site visit. Deliver clear, professional audit reports in English—accurate, timely, and...

Department:10116 Enterprise Corporate - Administration: Medical Staff ServicesStatus:Full timeBenefits Eligible:YesHours Per Week:40Schedule Details/Additional Information:This role covers two hospital sites Condell Medical Center and Good Shepherd Hospital. It is also hybrid. 2-3 days a week in office and the rest from home.Pay Range$30.70 - $46.05Leads, plans, organizes and is responsible for the day to day operations of the Medical Staff Services Department so that all aspects of the Organized Medical Staff are supported, including credentialing activities, professional relations, meeting management, and peer review activities. Additionally, compliance is maintained, with accrediting and regulatory agencies as related to the Medical Staff, including (but not limited to) Joint Commission, DNV, HFAP, CMS, OSHA, and State and Federal Law and other standards and regulations.Major Responsibilities:Implements, coordinates, monitors, and maintains effective credentialing processes for...